A naturalistic study of referred children and adolescents with obsessive-compulsive disorder

Gabriele Masi, Stefania Millepiedi, Maria Mucci, Nicoletta Bertini, Luca Milantoni, Francesca Arcangeli

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To report on clinical features, comorbidity, and response to pharmacotherapy in children and adolescents with obsessive-compulsive disorder (OCD) naturalistically followed and treated with serotonin reuptake inhibitors (SRIs). Method: A consecutive series of 94 patients (65 males, 29 females, age 13.6 ± 2.8 years), referred in the period January 2001-April 2004, diagnosed with a clinical interview (Diagnostic Interview for Children and Adolescents-Revised), and followed for 10 ± 6 months, were included in the study. Results: Contamination obsessions and washing rituals were associated with less impairment than other subtypes of OCD. Aggressive sexual obsessions and checking rituals as well as symmetry obsessions and ordering-repeating rituals were more frequently comorbid with tic disorders. According to the Clinical Global Impressions-Improvement scale (score 1 or 2), 63 subjects (67%) were responders to treatment. Nonresponders were more severely impaired and had a higher number of comorbid disorders, namely, bipolar disorder and conduct disorder (p <.05). Forty-seven patients (50%) received an SRI monotherapy, whereas the other 47 (50%) needed other medications. Patients receiving SRI monotherapy were less severely impaired; had a later onset of OCD; were at a younger age at the visit, had higher rates of depression and anxiety and lower rates of bipolar disorder, attention-deficit/hyperactivity disorder, and conduct disorder (p <.05). Conclusions: Long-term naturalistic prospective studies in pediatric patients with OCD might represent an important source of information for everyday care regarding the effectiveness of a treatment over extended periods of time under routine clinical conditions.

Original languageEnglish
Pages (from-to)673-681
Number of pages9
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume44
Issue number7
DOIs
Publication statusPublished - Jul 2005

Keywords

  • Obsessive-compulsive disorder
  • Selective serotonin reuptake inhibitors

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Developmental and Educational Psychology

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